Elizabeth Pattalis Nutritionist
SUSTAINABLE WEIGHT LOSS & INTUITIVE EATING NUTRITIONIST
The reality is at some point a weight loss diet will stop working. This is when people just give up, when they shouldn’t, it is part of the process and it can be overcome.
The body defends against weight loss.
Leptin is a signaller hormone for body fat. It is in proportion to how much body fat you have. The more body fat you have, the more leptin circulating in your blood.
If you drop body fat, your brain will hear it through leptin, and the brain doesn’t like that and will trigger a starvation response. It acts to maintain homeostasis in the body, think of leptin as a regulatory system of the body. Your body’s fat thermostat.
Subsequently, if your brain hears leptin has dropped then you start getting hungry, you start thinking about food more, food tastes and looks better and your metabolic rate may drop to preserve energy to replace the depleted stores.
This regulatory mechanism can malfunction, it can be reset to maintain a higher level. In industrialised countries this is happening, obesity is on the increase. People are gaining weight and it is difficult to lose that weight due to this leptin.
Leptin also does respond to recent food intake if you eat too much. If you eat a really big meal or overeat for days, your leptin will increase.
In obesity, it is frequent to see what is called leptin resistance.
The National Institutes of Health described leptin resistance as, “The failure of endogenous or exogenous leptin to promote anticipated salutary metabolic outcomes in states of over-nutrition or obesity.” (1). In other words, this is where you desensitise the leptin circuits and make them adapt to a higher requirement of leptin. Essentially the body requires more leptin to feel satisfied that you have enough body fat.
It important to note as well, this doesn’t happen so much if you are eating a healthy diet. It is something about high calories, processed, unnatural foods that has a greater impact on the leptin regulatory system.
Therefore in leptin resistance, where weight loss should see a decreased levels of leptin, this is not happening and this contributes to a vicious cycle of weight gain. A leptin resistance person requires more food than necessary to feel satisfied. In this person the brain not receiving the message that enough food has already been eaten.
When trying to lose body fat, do not give up once you plateau. Plateaus or to gain weight is very normal (most people will get this in weeks 6 to 8). Your diet may not be necessarily wrong for you. It is just that your body is now fighting really hard to get your thermostat body fat up again. Too many people give up right before the miracle happens, in many areas of life.
As a nutritionist, Elizabeth uses the latest research into the set point theory and leptin resistance when developing fat loss plans. This is why you don’t see strict weight loss diets from day one. This approach would send the body into starvation mode and cause havoc. It is not suitable if you want long term results. Do your research and think about the consequences before embarking on any diet ‘challenge’ you find online or developed as part of a weight loss competition. Your health is not a competition.
For more information on the effects of starvation and set point please read the article on the Minnesota Starvation Experiment.
To book in for a fat loss consultation please get in touch, bookings can be made online or contact Elizabeth directly.
Do you keep falling off the bandwagon?
Do you go from being really good to really bad?
Are you either strictly eating or are you junk food overloading?
Do you mess up so figure you may as well go all in?
If you answered yes to any of those, it is a tiring and unhealthy place to be. Eating is something we are born to do naturally without learning to survive. Yet we have turned it into an industry. This industry is killing us.
This is the key point here. Something done regularly even if it isn’t perfect gets you ahead.
It is far better to do one gym session a week than to do 1 every day but only make it two months before you stop going.
It is far better to eat well most the day except the chocolate bar at night post-dinner than do eat strict healthy for one month straight but follow it with a week-long binge.
Something is good enough. If you can only walk 2 lots of 15-minute sessions a day, do that!
Give up the shoulds and food rules. There is a point to eating a healthy dinner even if you ate maccas for lunch.
Healthy is knowing if you do have some cake that you’re body internally knows what to do with the extra calories. Healthy is trusting your body to know what foods it needs for nourishment.
Healthy is going to pilates because you like the feeling it gives you. Healthy is knowing that once a week is enough if that’s all you want to do.
Quit trying to look like someone you’re not. Eating to control your weight ends up making things worse. Eat for health. You can’t eat to look like Cindy Crawford. You can eat all the calcium-rich foods you like your legs aren’t going to grow longer! Accept the shape you are and work with it. Be the best you, you’re not competing with anyone.
If you stop having sugar with your coffee this time next year that will have made a big difference to your health. And it wasn’t something that was hard. A slight tweak here or there is what you need. Swap your mocha to a flat white. Swap your Sunday afternoon wine catch up with friends with a game of tennis instead. Walk to the corner shop each day instead of driving. Yes in one day you’re not going to see a result, but how about in a year? How about in 5 years?
You can do the keto diet for a month just to lose weight. There are lots of diets you can do. But can you sustain it? There are circumstances where it can be suitable to diet, but for most of us, there isn’t a need. Eating well isn’t about discipline. It’s what you should naturally want to do without too much effort. If it is an effort and you’re going back and forth, if you can’t say no to the dessert, then you need to address this. Free your mind so you can live life fully.
If you want to quit the cycle that gets you nowhere but usually backward if anything, then sign up to the 5 DAY FREE INTUITIVE EATING CHALLENGE. It starts on April 1, sign up today.
Break free from the diet mentality and learn how to listen to your own body.
Gaining weight on a diet is not uncommon, in fact, most people will experience this despite their best effects.
Have you ever lost a few kilos while being sick? Then once you were better your weight returns back to normal?
Or maybe you over ate too much on holidays returning back a little heavier? Yet effortless once you returned back to routine your weight bounced back?
This adaption is what we call set point theory, a theory developed in 1982 by William Bennet and Joel Gurin. The theory states that every human being has a ”setpoint”. The setpoint is a predetermined amount of body weight that indirectly balances how much food is eaten with how much energy is expended through physical activity and body metabolism (1). Some people will have higher set points than others and will have more body fat. It helps explains why people who go on diets rarely have long term success in achieving weight loss results, people tend to put the weight on plus a little extra.
Setpoint theory does explain why dieters sometimes lose weight fast initially but then plateau. The dieter begins to feel increasingly hungrier leading and eventually caves into the cravings. Subsequently, then the dieter returns back to normal eating. Dieters not only tend to put the weight back on, but they also put on extra weight. A study published in the journal Obesity studied 14 contestants of The Biggest Loser 6 years after the end of the show. Only 1 participant managed to keep the weight off. In addition to this finding, the weight regain did not come with a rebound in Basal Metabolic Rate (BMR). Therefore the contestants must eat fewer calories each day to maintain their weight than previous to the show (2). The body reacts to dieting similar to famine. It gives you extra weight as an ‘insurance’ and lowers your metabolism just in case famine strikes again.
If you think that is not bad enough, it gets worse. Neuroendocrine signaling and gut hormones adapt to changes after dieting. Leptin is a satiety signal that tells us when we are full. It may decrease when we are on a diet. Studies have shown that while leptin levels decrease there is also increased brain activity in areas of the brain involved in emotional and sensory control of food intake (3). Now the dieter has food always on the brain, it is no wonder why some dieters feel food obsessed.
So frustrating for the dieter! Losing weight is incredibly complex. You can now begin to appreciate why dieting is not simply about will power nor eating less. Now, this is not to say it will happen to everyone. However, it is one of the factors which explains why for some people they feel like they need to eat less and less to maintain their weight.
Before starting a diet it is important to consider the set point theory. There is no test to find out what your set point weight is. You can guess your setting weight is the weight you normally maintain, give or take a kilo when you’re not thinking about it.
It is possible to get around your set point and lose weight, it requires a systematic approach to ensure your BMR stays at a reasonable rate for long term weight loss success. The best approach is to lose weight slowly, eating a balanced diet in combination with exercise (4).
Seek advice from a nutritionist who specialises in the field of fat loss. A nutritionist uses the latest scientific research and tools to develop programs specific to the individual. If you’d like to find out if Elizabeth can help you, please contact her or book online.
The Challenge is a 5 Day program moving you from chronic dieting behaviour towards having a normal, carefree relationship with food.
Register HERE.
[Trigger Warning: This blog contains calorie counts which may be triggering for eating disorder sufferers].
The Minnesota Starvation Experiment is a well-known study which illustrates the negative health effects caused by diets. The study began during World War II with the purpose of understanding human starvation to in order to help the famine relief efforts after the war.
36 men were chosen. During the 12 month control period, the men received 3200 calories of food. This was followed by 6 months of semi-starvation in which they received about 1570 calories per day. The last three months was a nutritional rehabilitation period in which they were gradually refed, 2000 – 3000 calories per day.
During the study, the men were expected to live as they normally would and to walk 35 km a week and burn 3000 calories per day.
In the 6 month semi-starvation period, the men lost about 25% of their body weight. By the end of this 6 months and by the end of the rehabilitation period, the men experienced dramatic physical, social and mental changes.
One participant described the eating rituals men developed. Some people diluted their food in water to make it seem like more. Others would put a little food in their mouth and hold it in their mouth for a long time to savor it. Some meals could take two hours to consume when normally it would have been over in a matter of minutes. Chewing gum, coffee and tea consumption increased dramatically in the experiment as well. Many of the men started collecting cookbooks and one reported to owning nearly 100 by the time the experiment was over.
Food became the main topic of conversation and day time dreams. Concentration on other activities non-food related became difficult as food preoccupied their thoughts instead. One man interviewed in 2003 commenting on the food obsession said, “if you went to a movie, you weren’t particularly interested in the love scenes, but you noticed every time they ate and what they ate”.
The obsession was so great that three of the men ended up changing careers becoming professional chefs after the experiment.
During the refed period many men started binge eating. They could no longer control their appetites and were more or less eating continuously.
3 months post refeed period some men were consuming 6000 calories on most days and on the weekends close to 10000 calories per day. 5 months later some still reported to no longer being able to feel satisfied eating despite eating abnormally large amounts of food.
One man reported that after the starvation period it was “no better”, “partially because there was not a noticeable relief from feelings of hunger”. Another man described the next year as a “year-long cavity” that needed to be filled. Another after the experiment had to be taken to hospital due to get his stomach pumped because “he overdid it”.
Not all men completed the study. Two volunteers broke diet; one stopped at various shops for sundaes and malted later stole food and another admitted to chewing excessive amounts of food and eating food scraps from garbage cans. Both also suffered severe psychological distress during the semistarvation period, resulting in brief stays in a psychiatric ward.
During the experiment, the men reported anger outbursts, depression, anxiety and mood swings, and. They experienced fatigue, dizziness and lack of coordination, They lost interest in sex and their relationships began suffering. They also withdrew from social interaction preferring to be alone.
Physically the men looked gaunt, lost strength and lost stamina. They lost hair and experienced muscle soreness. Internal physiological changes were also apparent with lower body temperature, decreased heart rate, decreased respiration rate and the metabolic rate dropped 40% than prior to the experiment.
Food restriction can be incredibly damaging. Eating disorders often stem from having been on restrictive diets. When a person deprives themselves of food, they become fixated on food, the drive for food and survival goes into full swing. Binge eating can be the consequence of being undernourished for too long, it is not due to lack of will power. Other effects from prolonged dieting include digestive issues, hormonal imbalances and mood disturbances.
If you want to lose weight there is a right and wrong way to do it. As you can see from the experiment, the participants consumed 1570 calories. Many people are following diet online plans which contain less calories than this.
I help people eat intuitively, healthily without the restrictions, consistently. Lifestyle recommendations are part of the plan. Working with a nutritionist gives you the support to keep going and make adjustments so that you keep losing weight (assuming you need too). To book please use the contact page.
You may also download your free guide to help you find food freedom and break from binge eating.
Baker, D., Keramidas, N. (2013). The psychology of hunger. Monitor on Psychology, 44(9), 66-66.
Kalm, L. M., & Semba, R. D. (2005). They starved so that others could be fed: Remembering Ancel Keys and the Minnesota Experiment. Journal of Nutrition, 135, 1347-1352.
The Australian Health and Welfare 2018 Report released recently highlighted that 45% of Australians will experience a mental illness at some point in their lives (1). The need to address mental health is increasingly becoming evident.
A recent study (2) by the Food and Mood Centre at Deakin University in Melbourne, the Smiles Trial, sought to explicitly seek to answer the question, “If I improve my diet, will my mental health improve?” The results indeed were promising emphasising the need to eat a healthy diet to support mental health including managing depression. When it comes to mental health nutrition can be a powerful influencer.
The dietary composition of the diet in the study was as follows: protein 18% of total energy (E); fat 40% of E; carbohydrates 37% of E; alcohol 2% of E; fibre/other 3% of E.
The 40% of daily food coming from fat is not surprising when you consider the ‘dry weight’ of the brain is composed of about 60% fat. The fats we eat directly affect the structure and substance of the brain cell membranes. Saturated unhealthy fats are those that are hard at room temperature, like lard. They make the cell membranes in our brain and body tissue less flexible. Whereas we need a healthy balance of essential fatty acids omega-3 and omega-6 as these provide vital functions in the structuring of brain cells, ensuring that smooth communication is possible within the brain. Both are found in equal amounts in the brain, and it is believed they should be eaten in a ratio of 1 to 1. Unequal intakes of omega-3 and omega-6 fats are implicated in a number of mental health problems, including depression, and concentration and memory problems (6).
Omega 3 fatty acids are found in walnuts, flaxseeds, chia and fatty fish (3). Omega 6 fats can be found in foods such as soybean oil, corn oil, beef, poultry, eggs, and nuts. Omega 6 fats can be found in a lot of unhealthy food such as chips, pizza, desserts, dressings and processed meats (4)
In addition to eating the right ratio of fats in our diet for mental health, the Smiles Trial diet can teach us that a more traditional style of eating is effective for our mood.
This includes eating more whole grains, vegetables, fruit, legumes, raw nuts, fish, chicken, lean red meat, eggs, and olive oil. It is just as important to reduce the intake of ‘extra foods’ including sweets, fast food, sugary drinks, refined cereals, and fried foods.
The take-home message simply put, what you eat affects the structure and function of your brain. For optimal well-being including mental health, eat foods in their most natural forms and avoid processed foods
If you’d like to understand better how food can be used as a tool to improve your mental wellbeing book in for a consultation with Elizabeth. Mental health is an area she is passionate about. By helping one person at a time each of us can make a difference in improving the wellbeing of others too.
There are many female hormonal conditions. Conditions include amenorrhea, PMS, perimenopause, and PCOS. The ones below are just three of the main ones I see in clinic. Regardless of the condition, how to treat hormone imbalances starts with the same theory. I do not treat the disease but the individual and their presenting symptoms. It is always important to remember you are not your disease and everyone has different biochemistry, therefore no two treatment plans are the same.
Polycystic Ovary Syndrome (PCOS)
PCOS is the most common endocrine disorder in females of reproductive age. It is a complex reproductive, endocrine, metabolic and psychological condition. Women with PCOS have a higher risk of heart disease, diabetes, depression, anxiety, and body image issues. Insulin resistance has been implicated in PCOS. PCOS represents the most frequent cause of irregular or absent menstrual periods and infertility.
For diagnoses, ultrasound can be used to check for polycystic ovaries. Blood tests include androgen levels, thyroid function, prolactin, FSH and glycaemic status. There is no specific test as it is a group of symptoms related to lack of ovulation and high levels of androgens (testosterone, DHEA s).
Main symptoms include:
Risk factors include:
Treatment:
Treatment depends on the type of PCOS you have. Your practitioner needs to consider your type eg are you insulin resistant, do you have irregular periods, do you have inflammation, do you have high androgens, do you have inflammation and were you on the pill? As PCOS can vary per person the best thing is to consult a practitioner. Some nutrients a practitioner would consider include magnesium, zinc, NAC, fish oils, curcumin, vitex, peony, and licorice. If you have insulin issues quitting sugar is essential. Exercise is also important in all types of PCOS. If you are expressing symptoms of PCOS it does not mean you always will. With the right plan, you can have regular periods and your symptoms can be improved or treated completely.
Endometriosis is an inflammatory disease and affects 1 in 10 women. It is a condition where the uterine lining tissue, grows in places other than the uterus including the bladder and bowel. These can be called lesions. Its main symptom is the pain. It is a pain that is severe and can last many days. It affects a person’s life quality as it often means taking days off work or being unable to perform daily activities.
Other symptoms include:
There is no known cause. It appears to be associated with immune dysfunction. There is also a strong genetic component to it.
Hormones do play a role in endometriosis although it is an inflammatory disease. Estrogen stimulates the growth of lesions.
Treatment:
There currently is no cure. Treatment can relieve the symptoms. Surgery is a conventional approach but it is not a permanent fix. The lesions grow back and often surgery is repeated.
In managing the symptoms reducing inflammation is key. Avoid cow dairy, gluten and consider avoiding eggs. Nutrients that a practitioner may consider include turmeric, zinc, NAC, selenium, alkaline minerals, vitamin D and fish oils. It may also be useful to check for histamine intolerance.
The transition to menopause can be problematic but menopause itself can be symptom-free (perimenopause is for another post).
During menopause levels of estrogen and progesterone are much lower.
Some symptoms include:
Associated risk:
Hormonal conditions are complicated and as mentioned at the beginning of the post, the best approach to manage it will depend on your hormonal profile. If you’d like to discuss if nutritional medicine may be appropriate for you please make a booking for a free 15 minute discover call.
Alternatively, download your free hormone reset guide which explains the main hormones and simple steps you can start now to find balance to feel yourself again.
Healthy hormones aren’t just about hormones. Hormones need your whole body and lifestyle to be working to support each other.
Below is a list of factors to consider when balancing your hormones. It is important to get to the root cause and to also get the foundations right if you have hormonal problems.
Stress contributes to many chronic conditions including hormone imbalances. Stress increases cortisol which is made by the adrenals. This fight or flight hormone helps you in dangerous situations or other acute challenges such as infections. It is meant to be released in short-term survival, eg imagine if you were being chased by a tiger. Then you would want cortisol released to get blood flow to your limbs. During this time processes such as digestion aren’t a priority, but instead, your body is focused on keeping you alert, raising your heart rate and raising your blood sugar for energy.
Cortisol is not meant to be pumped through your body constantly. Chronic stress puts your body under chronic cortisol activation. This reduces your sensitivity to insulin and also can shut down your ovulation. Your body does not want to reproduce under stress. This then leads to what is called HPA dysfunction.
This is impaired communication between your hypothalamus, pituitary, and adrenals. It is caused by stress where cortisol activation has been prolonged but also can be due to factors such as poor sleep, under eating, nutrient deficiency, and circadian disruption. Blood sugar problems can cause HPA dysfunction too. If you have blood sugar regulation problems you want to ensure your eating low GI. You can get your cortisol levels checked and also you could get a blood test to check your DHEAS. DHEAS can become low during chronic stress.
I’m often telling clients to add sweetness into their lives and I’m not talking the food kind. Happiness and rest make a dramatic difference to your life. If you are constantly trying to make other people happy you’re going to slowly kill you inside. I mean that emotionally. Life is short. I like to think of it as an adventure.
Start small if you must. Maybe for you, that is one hour a week where you dedicate just to taking care of you. Some examples may be going to a yoga class, getting a massage, having a facial, laying at the beach, playing a game of tennis, cooking or reading a novel. Do something you like and you know will help you feel good.
Exercise is important for hormones. The type of exercise you choose is up to you. The best form is always what you enjoy the most and that you’ll do. If exercise really just isn’t something you can get yourself to do, I do encourage you to try a personal trainer. I also offer group Pilates classes which is gentle but still effective.
Regular exercise benefits us in numerous ways, it helps with the cortisol stress response, it improves sensitivity to insulin (important in PCOS), reduces inflammation and improves circulation to your pelvic organs.
Inflammation is a good thing in the right amount. It helps the body in times of infection or sickness. But, when we have too much, then we have problems. The inflammatory cytokines that are chemical messages which fight the infections can block or reduce communication between your hormones. Different parts of the body talk to each other. Eg your pituitary talks to your ovaries and this happens with hormones. If there is blocking well then you’re not going to ovulate or it may be unpredictable. Not only this, but inflammation can block the receptors for your hormones and can hyperstimulate receptors for estrogen and testosterone.
Sources of inflammation include:
You need to remove the source of your inflammation and also be consuming anti-inflammatory foods. Vegetables are powerful at reducing inflammation with their phytonutrients and antioxidants.
A note on phytoestrogens, these bind to estrogen receptors. They can benefit those with symptoms of excess estrogen. They include nuts, seeds, legumes, flax, and soy. It’s a little confusing but after menopause, they become pro estrogenic, therefore they can help relieve menopause symptoms.
Healthy hormones require nutritious food.
Supplements will vary depending on the individual and the exact hormonal problems. Below are a few of the most commonly prescribed ones:
As you can see from reading through all the different health areas that need to be addressed, hormones are tricky. But balance can be achieved. I have personal experience with PCOS and I successfully pieced together all the areas. With careful management I no longer have symptoms.
If you would like a health plan specific to your condition or imbalances please make an appointment. Guessing rarely works, professional advice with the right testing and the foundations set up can get you feeling yourself again.
If you missed part one please read here.
The DUTCH test, which uses dried urine, is the simplest, and informative test for anyone who suspects they might have a hormone problem. The test is done four times in a day, and the strips of dried urine are then used to give you a complete hormone panel, including metabolites.
Testing 4 times a day is important as hormones fluctuate during the day, it allows for a more complete picture of what is going on for you. Cortisol, for example, one of the hormones the test checks for, if this was low in the morning and then high at night, then you’re likely to be suffering insomnia, foggy brain in the morning and so on. If you just got a blood test, you’d only be capturing that one time which perhaps could be normal if you happened to do it at midday.
The test also captures metabolites which you don’t get in a blood test. These metabolites are extremely valuable for you to know. If you had a blood test and was told you are estrogen dominant, a common phrase, that would make you think you have too much estrogen. But it doesn’t tell you why. With the DUTCH it captures the estrogen metabolites eg 2-OH-E1. By looking at these metabolites you can determine if you have a problem with a sluggish liver and in what phase of liver clearance. Phase 1 and Phase 2 liver clearance requires different treatment approaches.
An example of the test is below. This test tells the practitioner that the patient is suffering from estrogen dominance and that their phase 1 liver detoxification needs support. This patient was treated with DIM and then retested, estrogen now has improved. But you would not want to give the patient DIM if there Phase 2 is the actual problem, you would then cause more estrogen to circulate through the body. The example illustrates why you cannot just guess. Guess wrong and you’re now suffering more.
As a health practitioner, I regularly use the DUCTH test with my clients. My advice tends to usually be, get your diet almost right first and then we can determine if you have a hormonal problem that needs to extra support.
Hormones it tests for include:
Plus markers including dopamine, serotonin (soon about to be phased out), norepinephrine, MMA (for B12 status), Xanthurenate (for B6 status) and Pyroglutamate (for glutathione status). These markers help with hormone metabolism/detoxification.
If you’d like more information or would like to get tested please contact me for a consultation. Bookings can be made online or contact me directly for appointments outside of what is available.